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2025 Sloan Place Suite 35 St Paul MN 55117 | |
(651) 772-1572 | |
(651) 772-1889 |
Full Name | |
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Speciality | Family Medicine |
Location | 2025 Sloan Place, St Paul, Minnesota |
Authorized Official Name and Position | Paul A Berrisford (CEO) |
Authorized Official Contact | 6517721572 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2025 Sloan Place Suite 35 St Paul MN 55117 Ph: (651) 772-1572 | 2025 Sloan Place Suite 35 St Paul MN 55117 Ph: (651) 772-1572 |
NPI Number | 1831100072 |
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Provider Enumeration Date | 08/11/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1831100072 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | 1417 (Minnesota) | Primary |
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